If you are new to the forums, you must register a free account before you can post. The forums have a separate registration from the rest of www.chronofhorse.com, so your log in information for one will not automatically work for the other. Disclaimer: The opinions expressed here are the views of the individual and do not necessarily reflect the views and opinions of The Chronicle of the Horse.

update post #112 Laminitis woes/vaccine reaction

I have a pregnant mare who was given a vaccine in January to which she had a violent reaction that has resulted in laminitis. This has been a really rough go of it. She was stable until 2 days ago when she has spiked a bounding pulse again, but my question is posed looking ahead to the future for when she might be stable.

She has lost weight which for a pregnant mare battling laminitis, this is both a blessing and a curse.

She's at month 7, specifically day 214. Her "due" date of day 340 is June 25, but quite frankly, the prognosis surrounding a successful "to term" live-birth foaling is very, very guarded.

Right now, I am battling for her life. But should we actually get to a guardedly optimistic outlook, and *if* she is still in foal by May 1st, then I will be looking to increase her protein without using soy (she has proven reactive to soy) and without increasing the sugar. I am wondering about alfalfa pellets.

My mare was healthy until the vaccine and she is not fat. Her laminitis is purely a complication to the very severe, life-threatening reaction to her vaccination. This is not totally unheard of, actually.

Within 6 hours of receiving the vaccine, she swelled up like a balloon with pitting edema even on her face. Vet was horrified, to say the least, and pumped her full of antihistamines and banamine, started her on Regumate, considered Lasix but decided only as a last resort if she started to go into organ failure and couldn't diurese herself. He warned of 2 things: (A) She might lose her foal, and (b) She might develop colic or laminitis as a complication to this reaction.

So, she went the laminitis route and we are waiting to see if she drops her foal.

Liver, kidney and heart function enzymes all tested normal, so this was a relief. A reaction this serious usually paves the way to organ failure. However, with good results, this cleared the way for maximum Bute of 3 grams a day. She does not have a thyroid problem, is not metabolic, and does not have Cushings. Her inflammatory markers were, not surprisingly, through the roof.

At the time of the vaccination, she was at month 5.5 of her pregnancy and was on nothing but timothy tested to be NSC of 11.7.

She seemed to be stabilizing and vet and farrier were happier with things at the end of January. Now into late February, she is at a point in her pregnancy where she requires a rising plane of nutrition. I can get by for now with Hoffman's minerals (no-calorie) and I have no problem putting her on soaked and rinsed beet pulp. But assuming she manages to maintain her pregnancy, by month 10, she will need more protein.

She is also losing weight and this is not a great idea for a pregnant mare to be losing a lot of weight as this can actually set off a severe metabolic problem and that, suffice it to say, would end her life. I would prefer her to maintain, because she's at a perfect weight.

Since protein source cannot be soy, it needs to be in the form of alfalfa and NOT HAY, since I can't find low ESC/NSC lucerne hay.

So, I repeat my question. If I soak the pellets and rinse them thoroughly will this lower the ESC and NSC to the lower values, her known safety zone between 4-9?

I am sorry that your mare (and you) is going through this, and I'm sorry to stray from your question, but for a mare with laminitis which was induced by a vaccine reaction, who has no metabolic issues processing sugar, is such a thing really a concern for her (do you need to be so guarded about her starch intake)? I would GUESS that soaking them would help, but I cannot say for sure. Hopefully Katy Watts will chime in.
Jingles for your girl!

Try contacting Elenore Kellon. She is an equine metabolic specialist who is very informed I. All things to do with laminitis, and I think she is one of the best vets in the country to consult with. She is very accessible and easy to communicate with. Try googling her. PM me if you can't find her contact info.

Hi Simkie, yes I can do that, it's no problem, but I was hoping someone had prior experience - if the answer was going to be "no, the soaking does nothing for alfalfa pellets", then I would not need to go through the bother. If there is a chance it does reduce it, then I have enough time to perform several samplings to send off for analysis. Her month 10 will start in May so there is time to get things figured out.

CrowneDragon, this is a valid question, but I would rather not experiment at this point.

Rodawn, the reason I asked about underlying metabolic issues is to clarification if this was some how just strictly related to the vaccination. If so I'm just not sure how a diet change would affect her future.

Dr. Kellon is fabulous and been a big help to me and my horse who on the surface appeared to have no metabolic issues and not horrible bloodwork results. However, after investigating a little further looking at his glucose insulin ratio and leptin levels as well as making changes to how we manage his diet we were able to figure out that although not text book insulin resistant he can't handle certain levels of NSC which therefore in all reality makes him metabolically challenged.

Anyways, Dr. Kellon has a yahoo group if you google it will come up. I'd recommend joining it the information and people are super helpful.

You must be so stressed. Kellon is the go to for this issue I believe. There is a Cushing's group on Yahoo which may be helpful even though your mare's laminitis is not due to that. The emergency laminitis diet last I checked included soaked beet pulp, soaked Timothy Balance Cubes by Ontario Dehy, IODIZED salt, magnesium. My experience with alfalfa for my laminitic horses has been disasterous. The Timothy Balance cubes are readily available in the places I've lived and were, I believe, developed by Dr. Kellon. They have proved a life saver for my guys. They consist of low NSC timothy, beet pulp and helpful minerals and such. Please check them out and good luck to you and your mare.

You must be so stressed. Kellon is the go to for this issue I believe. There is a Cushing's group on Yahoo which may be helpful even though your mare's laminitis is not due to that. The emergency laminitis diet last I checked included soaked beet pulp, soaked Timothy Balance Cubes by Ontario Dehy, IODIZED salt, magnesium. My experience with alfalfa for my laminitic horses has been disasterous. The Timothy Balance cubes are readily available in the places I've lived and were, I believe, developed by Dr. Kellon. They have proved a life saver for my guys. They consist of low NSC timothy, beet pulp and helpful minerals and such. Please check them out and good luck to you and your mare.

I agree with the above the emergency diet also includes flax seed and vitamin e.

So sorry for your troubles Rodawn! Alfalfa pellets pretty much dissolve and turn to mush when soaked, I'm not sure if they can then be rinsed. Alfalfa cubes would work better. And yes, I believe soaking and rinsing cubes will lower NCS. Like Simkie said, you would need to test both unsoaked and soaked to see the difference. Have you considered timothy cubes or pellets? They work well for horses needing low NSC, and can also be soaked.
Do you really need protien, or do you need amino acids and calories? Have you considered Quinoa? Wikipedia has a great page on it, with info on nutrients
As a bonus, Whole Foods has Quinoa proccessed into flakes in bulk (No soaking needed). I feed them as a suppliment because they contain all the essential amino acids, for calories, I add vegtable oil. Then just add a Vitamine/mineral suppliment and you should be good to go.
Remember, you must feed some stemmy fiber to keep her gut healthy So the cube form of alfalfa or timothy will give you that. Run every thing by your vet and make any changes gradually.

I am so so sorry for what you are going through. I have a horse who is hypersensitive to vaccinations and each year his reaction gets worse. Every year I have a long chat with my vet on how to prepare and handle it, and most of all how to stay on guard for the big L should he go that way. I am so so sorry.

Triple Crown alfalfa cubes came in with a protein of 13.6, and RFV of 93, nice high lysine of .69 and a combined NSC (WSC, ESC and Starch) of 16.4. Given that 7.4 of that was WSC (water soluble carbs) in theory a soaking could bring the alfalfa cubes down around the 10 mark for NSCs.

I agree about the alfalfa pellets, pouring off the water would be problematic.

You won't be able to rinse soaked a-pellets - they basically dissolve into little particles, as said. It MIGHT be possible to rinse/drain them through something like very fine cheesecloth, doubled up, but it would take a while and a lot of cheesecloth to allow all the water to come out.

I second trying beet pulp - the problem is the volume. It averages about 9% protein, according to E-A, so not as good as alf, but not "nothing" either.

You can also get straight lysine, since that's not going to be there in significant amounts in the beep.

Grayarabpony, Dr. Kellon who has a yahoo group has found some IR /Cushing horses can be sensitive to vaccines as well as wormer. I'm not sure of the studies as I didn't go digging for them but took the info for what it was. My horse has never had an issue so I didn't spend the time thoroughly investigating it. Lol learning about IR and how to manage my horse was time consuming enough.

Sorry to hear this rodawn, I hope your mare comes through ok. You were so supportive when my gelding passed away, I wish I had something useful to tell you...but this is all way beyond me. Sending positive thoughts your way.

It's Day 40 of our nightmare. She has deteriorated last night/today. My mare is going into liver and kidney failure (she is peeing tea-colored urine and is carrying edema throughout her body), so we've had to make the decision to quit all pain medications and hope that her functions return, even though she is still in a tremendous amount of pain. I brought in a whopping load of shavings to try to make the bedding soft and extremely deep and she seemed to appreciate this. Despite being confined 24/7, she has not developed any behaviour issues. We are all pretty sure she has ulcers, a reasoning for her weight loss, but cannot add yet another medication to her system at this point. I do my best to feed her with something at least 5 times a day in an effort to keep something in her stomach at all times.

Of course, this probably means she will abort the foal.

It's an ironic situation to be in, since I have actually discussed with my vet team about intentionally aborting the foal and they are against it since it could set her off into a spiral from which she might not recover, unless our hand was forced. Now, we might have no say and our hand is being forced. Continue the drugs = liver/kidney/heart failure = death of mare. Stopping the drugs = increased prostaglandin/inflammation = resurgence of laminitis and abortion of foal. Talk about being between a rock and hard place.

I cannot feed her salt since her kidneys are not excreting appropriately. Giving her salt now would force her to drink, and her kidneys would not excrete the excess water and this would cascade into heart failure.

I have already started her on magnesium at a very cautious dosage and iodized kelp tablets. I am using human grade because the dosages are exact and right now there is no room for approximations. The vet team is worried about the stress of the excess fluid on her heart and too much magnesium can exacerbate this. Her heart rate is a little higher than it should be, but not alarming, so we just hope she holds her steady.

If I had to map her course on a graph it would be up and down like a rollercoaster. She is a redhead and I hope this plucky mare digs deep. My own husband is a little horrified with my appearance as I'm running on a couple hours of sleep. Our treatment bill for medications and supplies averages about $200-250 per week. This does not include the vet.

Alfalfa cubes might be the way to go - I'm sidelining this decision at the moment until things stabilize and I get enough rest to think straight. Her stemmy timothy hay is appropriate for her for now, it's tested and low enough NSC/ESC.